Healthcare Provider Details

I. General information

NPI: 1164486957
Provider Name (Legal Business Name): ADOLFO N MILLAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13005 SOUTHERN BLVD STE 212
LOXAHATCHEE FL
33470-9272
US

IV. Provider business mailing address

13005 SOUTHERN BLVD STE 212
LOXAHATCHEE FL
33470-9272
US

V. Phone/Fax

Practice location:
  • Phone: 561-478-7422
  • Fax: 561-420-0766
Mailing address:
  • Phone: 561-478-7422
  • Fax: 561-420-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0026226
License Number StateFL

VIII. Authorized Official

Name: DR. ADOLFO NAVARRO MILLAN
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 561-478-7422